Internal Medicine Quiz | Practice MCQ #mcq.ImBooz

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1 >>Which of the following statements about clostridial infections are correct? ?

Internal Medicine Objective Questions | Internal Medicine Quiz

2 >>In which of the following patients should an anaerobic organism be considered as a potential etiologic agen ?

3 >>Which statement about varicella-zoster infection is correct? ?

4 >>Which of the following statements accurately describe cytomegalovirus (CMV)? ?

5 >>Which statement about viral gastroenteritis caused by rotavirus and Norwalk virus is correct? ?

6 >>Which of the following statements correctly characterize tetanus? ?

7 >>A 48-year-old man is admitted to the coronary care unit with an acute inferior myocardial infarction. Two hours after admission, his blood pressure is 86/52 mmHg; his heart rate is 40 beats per minute with sinus rhythm. Which of the following would be the most appropriate initial therapy? ?

8 >>A 68-year-old man with a history of hypertension, diabetes, and urinary retention awoke feeling nauseated and light-headed. He did not respond to questions from his wife. When the emergency medical technicians arrived, his blood pressure was 60 by palpation. IV fluids and oxygen were administered. Vital signs obtained in the ERwere blood pressure 60, heart rate 120 and regular, temperature 38�
C (102�F), and respiratory rate 30. A brief physical examination revealed coarse rales approximately halfway up in the chest bilaterally and inaudible heart sounds. An indwelling urinary catheter was placed with drainage of 10 to 20 mL of dark urine. Chest x-ray revealed bilateral interstitial infiltrates; ECG was unremarkable except for sinus tachycardia. Antibiotics were administered, and the patient was transferred to the ICU, where a right heart catheterization was performed. Pulmonary capillary wedge pressure was 28 mmHg. Cardiac output was 1.9 L/min. Right atrial mean pressure was 10 mmHg. The most likely cause of this man’s hypotension wa ?

9 >>Which of the following statements concerning the use of captopril is true? ?

10 >>A 55-year-old man with known coronary heart disease develops recurrent anginal symptoms 2 months after undergoing an apparently successful percutaneous transluminal coronary angioplasty (PTCA) procedure. The original PTCA procedure was performed because of angina unresponsive to medical therapy in the setting of two proximal 90% occlusions (one in the right coronary artery and the other in the left circumflex). Cardiac catheterization reveals that the left circumflex lesion has reoccluded. Which of the following statements concerning the patient’s current condition is correct? ?

11 >>A 67-year-old man who has experienced recurrent episodes of dizziness over the last several months is admitted to the hospital because of a fainting episode. No evidence of acute myocardial infarction is documented. On the evening of admission, the patient tells his nurse that approximately 10 min earlier he experienced several minutes of dizziness. His current rhythm appears to be normal sinus; however, a monitoring strip obtained at the time of this episode reveals absent QRS complexes every third beat. The PRinterval, while slightly prolonged, is constant from beat to beat. P waves are present at regular intervals. Which of the following is the most appropriate therapeutic action? ?

12 >>A 53-year-old man presents to the emergency room after the acute onset of chest pain. The episode occurred 8 h prior to his arrival and lasted for a total of 20 to 30 min. The chest pain is now resolved. The patient has a long history of diabetes mellitus and hypocholesteremia and has smoked approximately 1 to 1 1/2 packs per day of cigarettes for the past 30 years. On physical exam he has a blood pressure of 84/52, and his pulse is 54. He has jugular venous distention to the angle of the mandible and clear lung fields. His rhythm strip reveals a Wenkebach pattern. Given his hypotension, a Swan-Ganz catheter is placed. Right atrial pressure is estimated at 16 mmHg (normal 0- 5), pulmonary artery pressure at 20/10 mmHg (normal 12- 28/3- 13), and the pulmonary capillary wedge pressure is 8 mmHg (normal range 3- 10). Which of the following is most consistent with this clinical picture? ?

13 >>Examination of the carotid pulse reveals two impulses or peaks during ventricular systole. Which of the following physical findings probably would be associated with this finding? ?

14 >>A 65-year-old man with a long history of untreated hypertension complains of recurrent shortness of breath on minimal exertion. Examination of the cardiovascular system is normal except for a prominent precordial impulse. Chest x-ray is normal except for a prominent left ventricular shadow. An exercise tolerance test with thallium scanning reveals no evidence of myocardial ischemia. Two-dimensional echocardiography reveals left ventricular hypertrophy. Radionuclide ventriculography reveals normal right and left ventricular ejection fractions. What is the most likely explanation for the patient’s symptoms ?

15 >>Clues to the presence of atrioventricular nodal block (as opposed to trifascicular block) include which of the following? ?

16 >>Which of the following agents has been shown to reduce mortality in patients with congestive heart failure? ?

17 >>A 68-year-old Haitian man presents with a chronic nonproductive cough, dyspnea on exertion, and chronic nonexertional chest pain. The patient notes a loss of 10 pounds over the past 6 months, decreased appetite, and swelling of the ankles. Physical findings reveal an ill-appearing man with decreased skeletal mass. Blood pressure is 100/70 without a significant inspiratory decrease in systolic pressure. Heart rate is 110; respiratory rate is 25; temperature is 37.2�C (99.0�F) orally. Significant physical findings include the absence of rales on chest examination and the presence of jugular venous distention with a decline during inspiration. The apical cardiac pulse is reduced. The heart sounds are distant; an early third heart sound occurs very shortly after aortic valve closure; there are no murmurs. Both the liver and the spleen are enlarged, and there is a fluid wave on abdominal examination. Electrocardiography displays low QRS voltage but is otherwise unremarkable. Chest x-ray reveals clear lungs and an enlarged cardiac silhoutte. Which of the following findings is most likely to appear on echocardiographic examination? ?

18 >>Each of the following patients was noted to have an abnormally high serum cholesterol and was placed on a reduced calorie, cholesterol, and fat diet for the past 3 months. None has any history of ischemic heart disease. In which of the following patients would it be most appropriate to recommend lipid-lowering drug therapy at this time? ?

19 >>Which of the following statements regarding secundum atrial septal defect is true? ?

20 >>A 75-year-old man presents with recurrent episodes of shortness of breath on minimal exertion. He has no prior significant past medical history. Physical examination reveals blood pressure of 110/70 without pulsus paradoxus, heart rate of 110, respiratory rate of 25, and temperature of 37�C (98.6�F) orally. Jugular veins are distended and the heart sounds are distant, but there are third and fourth extra heart sounds. The liver is enlarged, and pedal edema is present. The electrocardiogram shows nonspecific ST-T wave changes and occasional premature ventricular contractions. The chest x-ray reveals clear lung fields and a mildly dilated cardiac silhouette. Echocardiography reveals normal systolic function and thickened ventricular walls with a “speckled” appearance. Which of the following conditions is most consistent with the patient’s clinical presentation? ?